Non‐alcoholic fatty liver disease comorbid with major depressive disorder: the pathological features and poor therapeutic efficacy
Abstract
BACKGROUND AND AIM: Major depressive disorder (MDD) is an important public health problem, and it is often comorbid with many chronic diseases. The purpose of this study was to identify the clinical features of non-alcoholic fatty liver disease (NAFLD) patients comorbid with MDD and to investigate the influence of MDD on the effect of treatment in patients with NAFLD. METHODS: A total of 258 patients with biopsy-proven NAFLD were included. MDD was diagnosed according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision. The patients were followed up for 48 weeks under standard care for NAFLD, which consisted mainly of lifestyle modification. RESULTS: There were 32 patients comorbid with MDD. They were characterized by more severe histological steatosis and higher NAFLD activity score, and also significantly higher levels of serum aminotransferase, γ-glutamyl transpeptidase and ferritin, than age-and-sex-matched NAFLD patients without MDD. Moreover, NAFLD patients with MDD showed poor response to the standard care for NAFLD, in body weight loss and in other parameters. Particularly, NAFLD patients with unstable MDD (not in full/partial remission) showed severe resistance to the treatment. CONCLUSION: This is the first study to demonstrate the clinical features and response to therapy of NAFLD patients comorbid with MDD. The comorbid state of MDD was associated with more severe histological liver steatosis and worse treatment outcomes in patients with NAFLD. Further investigations are required to develop new lifestyle modification programs that enable NAFLD patients with MDD to achieve the treatment goal.
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Depression and chronic liver disease are known to have some common underlying biological mechanisms.
“Depression and CLD are known to have some common underlying biological mechanisms.30”
From A Behavioral Health Program for Alcohol Use Disorder, Substance Abuse, and Depression in Chronic Liver Disease (2019) · cites this paper as [30]
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- Authors
- Tomeno, W., Kawashima, K., Yoneda, M., Saito, S., Ogawa, Y., Honda, Y., Kessoku, T., Imajo, K., Mawatari, H., Fujita, K., Saito, S., Hirayasu, Y., & Nakajima, A.
- Affiliations
- Yokohama City University (JP)
- Nagoya City University (JP)
- University of Miami (US)
- Corresponding author
- Nakajima, Atsushi
- ORCID
- Venue
- Journal of Gastroenterology and Hepatology
- Publisher
- Wiley
- Published
- 2015-04-27
- Volume
- 30
- Issue
- 6
- Pages
- 1009-1014
- ISSN
- 0815-9319 (ISSN-L)
- 1440-1746
- OpenAlex
- W1567967478
- Cited by
- 98
- References
- 28
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 17 · 2023: 10 · 2022: 17 · 2021: 12 · 2020: 9 · 2019: 7 · 2018: 4 · 2017: 4 · 2016: 1 · 2015: 2
- FWCI
- 2.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Young Scientists
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- non-alcoholic fatty liver disease, major depressive disorder, comorbidities, hepatic steatosis, NAFLD activity score, transaminases, ferritin, gamma-glutamyl transferase, lifestyle modification, treatment response, weight loss, depression remission
- MeSH terms
- Adult, Aged, Depressive Disorder, Female, Follow-Up Studies, Humans, Male, Middle Aged, Severity of Illness Index, Time Factors, Comorbidity, Treatment Outcome, Risk Reduction Behavior, Non-alcoholic Fatty Liver Disease
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